Himss10_blumenthal.mp4

Announcer [Music] Ladies and gentlemen, please welcome HIMSS Vice Chair Announcer who has been appointed to the HIT Standards Committee at the Department of Health and Human Services Announcer Liz Johnson! [Music] Liz Johnson Good morning, and welcome to the second Keynote of HIMSS 2010. Liz Johnson Over the first two days of our conference and exhibition, Liz Johnson we've had numerous opportunities to enhance our personal knowledge Liz Johnson by attending outstanding educational sessions, listening to exhibitor demonstrations, and participating in other activities. Liz Johnson As many of us have had the opportunity to attend our Awards and Recognition Banquet last night - it was a lot of fun, hope you were there! - Liz Johnson we had a great time and we were able to celebrate our HIMSS best and brightest achievers. Liz Johnson Thank you for being there and congratulations to all. Liz Johnson [Applause] Liz Johnson Today we have another great day planned, giving you a chance to make your experience even more fulfilling. Liz Johnson If you haven't already, I hope you stopped by the exhibit hall, especially the Interoperability Showcase. Liz Johnson The hall and Showcase will be open until 5:30 this afternoon, but will be closed tomorrow. Liz Johnson Today is your last chance to visit the Product Pavilion sessions. Liz Johnson If you haven't made plans for this evening, I encourage you to join us at the Georgia Auditorium Liz Johnson pardon me, how about the Georgia Aquarium Liz Johnson which is the world's largest aquarium with 16,000 square feet of exotic fish and animals from every region on the globe. Liz Johnson I also encourage the students in our audience this morning Liz Johnson to attend the Young Professionals Workshop from 1:30 to 3:00 this afternoon. Liz Johnson This event will give you the opportunity to network with our most seasoned and experienced members Liz Johnson and to learn more about HIMSS Young Professional Resource Center. Liz Johnson First on our agenda this morning is the HIMSS Annual Business Meeting. Liz Johnson On behalf of the Board of Directors, I am pleased to present this Annual Report Liz Johnson as part of the HIMSS 2010 Annual Conference and meeting of our members. Liz Johnson Our fiscal year runs from July 1st through June 30th, Liz Johnson so this report is for the period that ended June 30, 2009. Liz Johnson While this spring we were seeing the green shoots of emerging economic recovery, Liz Johnson the picture last year was very different. Liz Johnson The U.S. economy was in the grip of the worst economic downtown since the Great Depression Liz Johnson and this downtown was felt virtually everywhere, including by our individual members, our healthcare organizations, and our companies. Liz Johnson As the economy contracted, the ability to support professional development also declined, lowering revenues for HIMSS. Liz Johnson Our management team responded quickly, by reducing operating expenses to offset revenue decline, but with limits. Liz Johnson There were no cuts to member services, and no reduction in new service development efforts. Liz Johnson Even in the face of this severe economic challenge, there were some key accomplishments for this report. Liz Johnson ARRA passed with much input from HIMSS and its members, Liz Johnson followed by multiple education programs to help our members understand and prepare for this major federal IT investment opportunity. Liz Johnson Government HIT became part of HIMSS. Liz Johnson We added a magazine, a website, and a conference targeting government healthcare sector to our services Liz Johnson and we launched the first HIMSS Middle East IT Conference with nearly 400 in attendance. Liz Johnson At the year end, the financial report was an operating loss of about $2 million. Liz Johnson Throughout the year, the Board and our management team tracked this loss, Liz Johnson but we were firmly committed to continue our course with our current member services levels by not taking any further cuts. Liz Johnson HIMSS has saved funds for many years for this very purpose Liz Johnson and these strong reserves allowed us to cover the loss without harm to our organization. Liz Johnson HIMSS members can feel confident about our the future of our Society, Liz Johnson as reflected in the organization's strong balance sheet, in spite of this downturn. Liz Johnson The benefit of reporting today is that eight months into the next fiscal year, Liz Johnson we can report on how that strategy of protecting current member services and new service development worked Liz Johnson and that report is outstanding news: since July 1st, membership has increased by more than 16% Liz Johnson revenues are 22% higher than one year ago Liz Johnson and the year-end forecast is for all losses to be completely reversed. Liz Johnson I'd like to give a hand to the management team. Thank you. Liz Johnson [Applause] Liz Johnson Last year is not a year any of us ever want to see again. Liz Johnson We have weathered a very negative environment due to prudent governance and management. Liz Johnson Now we're on the other side. Liz Johnson The forecast is positive, and HIMSS is positioned to continue the drive toward achieving the best healthcare through information and management systems. Liz Johnson I want to thank all of you for your continued support and involvement in HIMSS. Liz Johnson It was certainly another outstanding year for HIMSS. Liz Johnson As healthcare IT continued to make important contributions to the transformation of healthcare, Liz Johnson each of our accomplishments resulted from the hard work and sacrifice of our members. Liz Johnson And I personally thank each of you and every one of you that contributed to today's successes. Liz Johnson Now let's watch the big screens to see how health IT and management systems made a difference in the delivery of healthcare and in the lives of patients. Video Narrator [Music] HIMSS members championed the cause and advanced the way Video Narrator As leaders in health information technology and management systems Video Narrator their shared experiences and professional expertise guide HIMSS to fulfill its vision of improving healthcare through the best use of IT. Video Narrator And that vision brings the reality of improved patient care. Video Narrator Clinicians, IT professionals, students, members and legislators share their perspectives on how the EMR has touched their lives and those of people they know. Video Narrator Urban Health Plan provides much-needed healthcare to the underserved South Bronx neighborhood it calls home. Video Narrator The 2009 HIMSS Davies Community Health Organization winner has served the community for more than 35 years. Young Man I lived in this neighborhood, I've come to Urban since I was a toddler. Young Man I definitely noticed a shift from paper records - how it was back then - and electronic records - how it is now. Young Man It's definitely a big change. You see more efficiency in the waiting room and how the doctors treat you Young Man and how they can go back and forth and reference records from before and records from now. Alison Connelly One of the biggest benefits of having an electronic health record at Urban Health Plan is that it gave us the opportunity Alison Connelly to do something really innovative around patient safety. Alison Connelly We're in a very heavily Hispanic area - for example, we have 102 patients with the name Maria Rodriguez - Alison Connelly so we decided to implement the use of iris recognition technology to identify patients. Alison Connelly So we make sure the right patient's treated at the right time. Alison Connelly And each patient when they come into the clinic looks into the camera and their medical record is instantly retrieved. Video Narrator Over 37,000 patients depend upon the quality and consistency of care provided at this Federally Qualified Health Center. Video Narrator Dr. Samuel DeLeon, Medical Director of the Clinic, explains the high-quality primary and specialty care provided. Dr. Samuel DeLeon I think the most important thing the electronic health record has provided for physicians is the ability to spend more time with patients. Dr. Samuel DeLeon In the past, we used to have to document on paper records. That took time from face-to-face interviews with patients. Dr. Samuel DeLeon So now, with the efficiencies that we have using electronic health records, we're actually able to provide more direct patient contact and communication with patients. Video Narrator The University of Wisconsin Hospital and Clinics ranks as one of only 39 Stage 7 hospitals in the U.S. Video Narrator The System serves Madison, WI and the surrounding counties with its main hospital, the American Family Children's Hospital, and 80 outpatient clinics. Video Narrator Achieving Stage 7 means this academic health center delivers improved and safer patient outcomes Video Narrator without paper charts during more than 554,000 annual clinic visits and 25,000 inpatient admissions. Donna Kate As an academic medical centers, our patients are highly complex - multiple diseases, chronic disease - and with the electronic medical record Donna Kate our 1300 physicians, no matter where they are located, 24/7 can get access to the information about a patient Donna Kate whether it's for a consult, or treatment while they come here, or in one of our regional outreach clinics Donna Kate we have access to everything about that patient at one time. Dr. Blaise Nemeth I think one of the things that the EMR has done to change how we care for our patients Dr. Blaise Nemeth is the transparency between inpatient and outpatient care and helping us prepare for them when they come into the clinic after they've been in the hospital. Dr. Blaise Nemeth In the old world, we wouldn't be able to get access to the paper chart because it was on the floor Dr. Blaise Nemeth or tied up somewhere or nobody knew where it was. Dr. Blaise Nemeth Now we can get into their records, see what we need to do when they come in, and be prepared for when they come into the clinic. Video Narrator As part of the university curriculum, student intern Chris Curatolo, a second-year medical student at Georgetown University and Navy veteran, Video Narrator came to HIMSS to learn more about information technology in healthcare. Video Narrator He completed his internship with a better understanding of health IT, public policy, and the benefits of the EMR. Chris Curatolo The HIMSS internship allowed us to take something that we were very passionate about Chris Curatolo and approach it not just on a clinic or hospital level but on a policy or strategic level. Chris Curatolo There is a clear need for physicians to address some of the problems facing healthcare Chris Curatolo at a policy level that can impact thousands if not millions of Americans. Chris Curatolo This summer I worked on the federal health record gateway, which aims to allow Americans, and specifically veterans, Chris Curatolo the ability to access medical information that's held with various agencies. Chris Curatolo For a veteran, this is specifically important because they're transitioning from the Department of Defense Chris Curatolo to being cared for by the VA as well as civilian healthcare. Video Narrator Each year the HIMSS Foundation awards more than $40,000 in academic scholarships Video Narrator to foster and encourage future leaders in the health IT and management fields. Video Narrator Past recipients of the scholarships are active HIMSS members, Video Narrator leaders who continue to work for the nationwide implementation of the EMR. Keri C. I first joined HIMSS as an undergraduate student at the University of Iowa on the recommendation of one of my fellow students Keri C. and at that time I was really looking for where I could go with my career. Keri C. I was an Industrial Engineering major and I could have gone a lot of different places Keri C. and healthcare for me was really a meaningful choice to get involved in, so I think that was a great recommendation there. Keri C. I then wasn't as involved in the first couple years of my career, but really got involved again when I went back to graduate school. Keri C. And I got involved at the local level doing a lot of chapter activities, as well as at the national level sitting on some committees helping to make some decisions there. Video Narrator HIMSS members make a difference. Video Narrator During the Public Policy Summit, they met with their members of Congress to educate them on the value of and need for health IT to improve healthcare. Video Narrator Members conducted more than 400 visits during this grassroots effort. Video Narrator They brought a local perspective to this national initiative, helping to move forward the adoption of health IT. Allyson Schwartz It's always valuable to have people who really understand and who really have a passion for the work they do to come and visit the members of Congress Allyson Schwartz particularly when we are involved in legislation that really affects what they do Allyson Schwartz particularly if they live in the district - that is particularly helpful. Allyson Schwartz But certainly when it comes to health information technology Allyson Schwartz for me I think and for many other members of Congress to really understand the difference it can make Allyson Schwartz in the kind of care that providers can offer to their patients and the difference it can make as we look for cost savings and improving quality. Video Narrator From HITSP to the HIMSS Medical Banking Project to the Alliance for Nursing Informatics and more Video Narrator HIMSS and its members lead the mission of improving the delivery of care to the use of health IT Video Narrator HIMSS members are the leaders who create the solutions, driving this transformation and ensuring that interoperable electronic medical records are in place. Video Narrator This is the time for you, to champion the cause, and advance the way as a leader in health information technology and management systems. Liz Johnson What a great year. [Applause] Liz Johnson I would also like to thank the sponsors of this Keynote Session. Liz Johnson Siemens and EMC now welcome Gail Latimer, Vice President and Chief Nursing Officer at Siemsn, to the podium. Gail - [Applause] Gail Latimer Thank you Liz. Good morning. On behalf of Siemens and its partner EMC, it is my pleasure to have the opportunity Gail Latimer to support this morning's Opening Keynote Speaker, Dr. David Blumenthal. Gail Latimer Dr. Blumenthal was appointed on March 20, 2009 as the Obama Administration's choice to serve as the National Coordinator for Health Information Technology. Gail Latimer As the National Coordinator, Dr. Blumenthal is leading the formation of a nationwide information technology infrastructure Gail Latimer that carries the ultimate goal of improving health and healthcare with the use of health IT. Gail Latimer With the passage of the ARRA HITECH, a stake has been placed in the ground to embrace IT adoption and meaningful use. Gail Latimer And while we have a good grasp of the vision, we need to achieve a better understanding of the details that will be required to get us there. Gail Latimer If you review Dr. Blumenthal's writing, you know he's a strong believer that health IT transformation cannot occur without the active participation of both the public and the private sector. Gail Latimer That is why it is critical and important that as leaders of health IT, we actively engage in this national dialogue on meaningful use. Gail Latimer We need to ensure that our voices are heard and considered in the content of the final rule. Gail Latimer Stakeholders all over the country, hospitals and physicians, vendors, industry associations are diligently working to get their comments back to the Office of the National Coordinator and CMS by March 15. Gail Latimer And leading the charge to review the public commentary is Dr. Blumenthal. Gail Latimer In fact, it's a good thing he's with us today. Gail Latimer After March 15, Dr. Blumenthal and his staff will be very very busy sorting through no doubt volumes and volumes of stakeholder feedback. Gail Latimer Admittedly, there are many challenges that lie ahead. Gail Latimer However, as the healthcare industry takes steps towards the embracing of health IT, we will be collectively changing the healthcare we will be delivering for generations to come. Gail Latimer I look forward to hearing what Dr. Blumenthal will provide us today as we pave a way into a new future of improving patient care. Gail Latimer What an exciting, exciting time to be part of a wonderful industry we call healthcare IT. And now let me hand things back to our HIMSS Board Vice President, Liz Johnson, Gail Latimer And thank you very much and enjoy the HIMSS Conference. [Applause] Liz Johnson Thank you Gail for your comments. Now let's watch this video to learn more about Dr. Blumenthal and his very important mission. [Music] Announcer Connecting opportunity is more than simply making connections. It's about knowing how to leverage the moment, Announcer being informed, and having the imagination to see how you can improve the future. Announcer Our next guest is the National Coordinator for Health Information Technology. Announcer Appointed by President Barack Obama, he is charged with building an interoperable, private and secure nationwide health information system Announcer and supporting the meaningful use of health IT utilizing the $2 billion allocated in the American Recovery and Reinvestment Act. Announcer As part of his role, he has already announced that ONC will establish up to 70 Regional Extension Centers Announcer to support providers in adopting and becoming meaningful users of health IT, Announcer establish state-based electronic exchange programs to support the electronic exchange of health information within and across states, Announcer establish up to 15 Beacon Communities to demonstrate the full potential of health information exchange in diverse areas including rural and underserved communities, Announcer establish programs to develop the health IT workforce Announcer and create up to four advanced R&D projects to identify promising new technologies. Announcer ONC also created two Federal Advisory Committees, the HIT Policy Committee and the HIT Standards Committee Announcer to gather public input and provide expert recommendations about health IT use in the United States. Announcer Educated at Harvard College, Harvard Medical School, and the Harvard Kennedy School of Government, Announcer he served his residency in Internal Medicine at Massachusetts General Hospital. Announcer A recipient of a Distinguished Investigator Award from AcademyHealth and a Doctor of Humane Letters from Rush University, Announcer he is a member of the Institute of Medicine and a former board member and national correspondent for the New England Journal of Medicine. Announcer A resident of Boston with his wife and two children, please welcome Dr. David Blumenthal. [Music and Applause] Dr. David Blumenthal Good morning. It's great to be here. I want to thank you so much for having me. Dr. David Blumenthal I want to thank you for welcoming me into the community of health information technology. Dr. David Blumenthal I'm a newcomer to HIMSS, I'm a newcomer to this world of information technology Dr. David Blumenthal and as a matter of fact for me at this inaugural appearance at HIMSS I'm reminded of the story Dr. David Blumenthal about the assistant rabbi who presided over his first service. Dr. David Blumenthal And he asked his mentor, the head rabbi, what his mentor did to calm his nerves. Dr. David Blumenthal And his mentor confided that if occasionally he was really nervous, he would fill his water glass with a martini. [Laughter] Dr. David Blumenthal So the assistant rabbi went up and did his service and he came back to talk to his mentor and asked how he did. Dr. David Blumenthal And his mentor said, "Well, first I'd take the olive out." [Laughter] Dr. David Blumenthal "Second, I sip it, I don't take it down with one gulp. And third, David slew Goliath; he didn't knock the bleep out of him." [Laughter] Dr. David Blumenthal Well, what has reassured me most in the ten months that I've been in this position Dr. David Blumenthal has been the support and good wishes, the terrific advice, the volunteered time and commitment Dr. David Blumenthal of so many members of this audience and so many people who aren't in this audience. Dr. David Blumenthal The overwhelming sense that I felt that you wanted us to succeed just as we want you to succeed. Dr. David Blumenthal You have been leaders. We want you to continue to be leaders. Dr. David Blumenthal And we will follow your lead trying to help you at every step of the way. Dr. David Blumenthal Since I am new to this community, some of you may be wondering who I am and how I got here. Dr. David Blumenthal I'm a primary care physician, and as you've heard, I was a professor. Dr. David Blumenthal I got to electronic health records and health information technology not as an informatician or as a computer programmer, amateur or professional Dr. David Blumenthal but because about 10 years ago an electronic health record landed on my desk courtesy of my employer, Partners Health System in Boston. Dr. David Blumenthal My wife by the way when I tell this story thinks that it was an enormous failure of vetting that I got to this job at all. Dr. David Blumenthal I confess that this electronic health record business and me was not a match made in heaven. Dr. David Blumenthal I was trained with paper, I was comfortable with paper, I liked my prescription pad. Dr. David Blumenthal I liked writing those x-ray requisitions in triplicate. Dr. David Blumenthal I liked my dictaphone. I didn't really see the need for change. Dr. David Blumenthal But I had a lot of younger colleagues, and they had a very different view of electronic health records. Dr. David Blumenthal And physicians are often a competitive group, and I really didn't want to be left behind, so I started working on it. Dr. David Blumenthal And gradually, slowly, I found that it was making me a better doctor. Dr. David Blumenthal I knew when my patients came in having been to the dermatologist and having had a mole biopsy - I knew what the pathology results were. Dr. David Blumenthal I knew what their mammogram results were. Dr. David Blumenthal I could tell what they needed to know when they needed it. Dr. David Blumenthal I remember vividly what for me was the point of no return for electronic health records. Dr. David Blumenthal When I was discharging a patient from the hospital, and entered into the order entry system a prescription for Bactrim, Dr. David Blumenthal which is a sulfa drug, and in bright red letters across the screen came a warning: this patient is allergic to sulfa. Dr. David Blumenthal And my professional career flashed before my eyes. I could imagine a patient in anaphylactic shock Dr. David Blumenthal and I knew at that point that this as something that truly added value to my work. Dr. David Blumenthal I greatly enjoyed and appreciated those middle-of-the-night calls when a patient not known to me Dr. David Blumenthal would present with a system and I could with secure VPN access, get into that patient's record, Dr. David Blumenthal find out what medications they were on, what problems they had, what their most recent visit had involved Dr. David Blumenthal and make a much much more informed and intelligent decision about whether that patient needed to go to the emergency room Dr. David Blumenthal or could stay at home and call their primary care physician Monday morning. Dr. David Blumenthal So I came to understand that information is the lifeblood of medicine and that health information technology is destined to be its circulatory system. Dr. David Blumenthal I wanted to be part of that future. I wanted to study it as an academic, and then I wanted to be part of making it happen. Dr. David Blumenthal But I came to health information technology because of its value to my patients. Dr. David Blumenthal Because of its promise for individual and population health. Dr. David Blumenthal I understood how important the technology was, but I was and am focused on its benefits for the American people and for our healthcare system. Dr. David Blumenthal And I think that has become - I hope it's become - the focus of public policy with respect to information technology as well. Dr. David Blumenthal As long as we keep the patient and their needs and desires as our North Star, our guiding light, we will not go astray Dr. David Blumenthal in our efforts to implement health information technology. Dr. David Blumenthal This has been a challenging and exciting year. Dr. David Blumenthal On February 17, 2009, President Obama and the Congress let the world know that the American healthcare system had entered the 21st century. Dr. David Blumenthal He and they set the huge goal of making electronic health records available to all Americans by 2014. Dr. David Blumenthal That's the promise of the HITECH Act, which I and my colleagues in federal government are charged with implementing. Dr. David Blumenthal It is a huge unprecedented ambition. Dr. David Blumenthal No one in the history of healthcare, or in the history of any other sector, has tried to do something as complicated, as difficult, in such a large, heterogeneous, diverse country Dr. David Blumenthal with the kind of independence of spirit and commitment to local autonomy and professional autonomy that we have in our healthcare system in the United States. Dr. David Blumenthal Fortunately, the Congress also gave the Department of Health and Human Services and my office and the Center for Medicare and Medicaid Services Dr. David Blumenthal some very powerful weapons, though also some very tight timeframes. Dr. David Blumenthal And our primary goal over the last ten months has been to bring those tools to life in support of your work. Dr. David Blumenthal Ours is not a big office. We can still fit in a school bus, we have about 55 employees, we are growing. Dr. David Blumenthal But we are a very dedicated, talented, hardworking group. Dr. David Blumenthal It's been my privilege to work with my colleagues, but we are small in number and continue to need your support and your advice. Dr. David Blumenthal We've accomplished I think quite a lot. Dr. David Blumenthal In the area of regulation we've accomplished four important regulatory breakthroughs. Dr. David Blumenthal The first of course is working with the Center for Medicare and Medicaid Services on the publication of the proposed rule on meaningful use. Dr. David Blumenthal This is the first time I believe that any country has laid out in black and white what it might expect - what it should expect - of a modern electronic health information system. Dr. David Blumenthal What goals, what tasks that technology should be able to assist with and help us to accomplish for our patients and our population. Dr. David Blumenthal Though there are many countries that are further ahead than we are in implementing the technology, I don't think any has laid out that kind of a vision. Dr. David Blumenthal It is an ambitious vision, it is an evolving vision. Dr. David Blumenthal Our goal as I've said in other audiences is to get the healthcare system providers on an escalator toward increasingly complicated, increasingly sophisticated, increasingly beneficial uses of health information technology. Dr. David Blumenthal The one thing I'm confident of is that every element in the meaningful use matrix has a direct link to the health of patients, the health of populations, and the efficiency of our healthcare system. Dr. David Blumenthal If there's any element in that matrix that doesn't have that link, it doesn't belong there Dr. David Blumenthal because as I've said before, our purpose is to improve health and improve efficiency, not to install technology. Dr. David Blumenthal We are with all these regulations going to be hearing your comments - we welcome your comments, we depend on your comments to make these regulations better. Dr. David Blumenthal The second regulatory action we took of course was the Interim Final Rule on standards and certification criteria Dr. David Blumenthal also a first - the first time this country has ever in regulation officially adopted standards and certification criteria for electronic health records. Dr. David Blumenthal We tried hard in that Interim Final Rule to balance competing objectives. Dr. David Blumenthal On the one hand, the objectives of providing certainty, predictability, consistency in the form of standards that would allow and guide interoperability. Dr. David Blumenthal On the other hand, we tried to allow for flexibility, we tried to meet providers where they are in addition to where we hope they will be Dr. David Blumenthal and we wanted to make sure that the standards we put into regulation - regulation which is time-consuming to change - would not inhibit critical innovation which you are all so committed to. Dr. David Blumenthal This is the first step in the regulatory process with respect to standards and certification. Dr. David Blumenthal This will be an evolving set of standards and certification criteria. Dr. David Blumenthal It will follow the escalator of meaningful use changing over time. Dr. David Blumenthal A third regulatory action was just announced yesterday, in the form of a notice of proposed rulemaking on a certification process. Dr. David Blumenthal I hardly need to remind you that the Congress tasked us with keeping or recognizing a certification process for electronic health records and health information technology. Dr. David Blumenthal Because of the importance of this new initiative, our General Counsel informed us that we had to establish a certification process through regulation Dr. David Blumenthal through a process that had all the openness to public comment and public scrutiny that only a regulatory process requires and assures. Dr. David Blumenthal We have endeavored with the advice of our Health Information Technology Policy Committee to create a certification process which is open, transparent, competitive, fair Dr. David Blumenthal and which we hope will have a dynamic that leads to an efficient certification process over time. Dr. David Blumenthal The regulation sets up a temporary certification process and a permanent certification process. Dr. David Blumenthal The temporary process is designed to get up and running quickly so that it can be available to certify records for the 2011 meaningful use period. Dr. David Blumenthal It allows for the recognition together of testing and certification. Dr. David Blumenthal The permanent process is intended to be more rigorous, to follow the standards that are set internationally for certification processes in this and other industries Dr. David Blumenthal and provides for the separate accreditation of testing of electronic health records and certification of electronic health records. Dr. David Blumenthal The separation of these two functions is recommended by the National Institute on Science and Technology Dr. David Blumenthal which is the government's primary expert and standards setter on certification and how it's conducted. Dr. David Blumenthal An important aspect of the new regulation is that it allows for the certification of both complete electronic health records and modules of electronic health records, Dr. David Blumenthal a change which we think is very important to allowing innovation in the architecture of electronic health records and also for flexibility and innovation in all respects. Dr. David Blumenthal The temporary certification process has a 30-day comment period because we want to get it up quickly. Dr. David Blumenthal The permanent process allows for a 60-day comment period, which is more traditional of rules in federal government Dr. David Blumenthal and here again we look for your comments. Dr. David Blumenthal All our regulations include questions directed to you, asking for your advice, and we hope you will look to those and respond to us. Dr. David Blumenthal A fourth regulatory action also announced this week was new guidance on the implications of CLIA for health information exchange. Dr. David Blumenthal We have been concerned as I know you have been that the interpretation of CLIA has sometimes stood in the way of easy information exchange Dr. David Blumenthal and our partners at the Center for Medicare and Medicaid Services have recently issued these clarifying guidances which encourage the use of certain standards for exchange of laboratory data. Dr. David Blumenthal Specifically, HL7 2.5.1 and LOINC say that visual inspection of electronic health interfaces is not necessary within an electronic health record installation, Dr. David Blumenthal say that patient access to laboratory data is permissible under CLIA, unless a state specifically prohibits it, Dr. David Blumenthal says that laboratory data can be transmitted through a health information exchange organization and supports the general concept of meaningful use. Dr. David Blumenthal We think these are very important steps forward to reduce any perceived barriers to meaningful use under, as a result of interpretations of CLIA. Dr. David Blumenthal In addition to these regulatory actions, we've announced a wide range of programs designed to support meaningful use. Dr. David Blumenthal The reason we have announced such a wide variety using the $2 billion in discretionary funds that the Congress made available to us is that in a project of this magnitude, Dr. David Blumenthal in an effort to create what amounts to social change rather than technology installation, it is absolutely essential to make a multimodal, multi-factorial approach to the problem. Dr. David Blumenthal We need to approach and support change from many directions at the same time. Dr. David Blumenthal So first we announced a nearly $700 million program to support Regional Extension Centers throughout the United States. Dr. David Blumenthal These Regional Extension Centers are focused on supporting initially the achievement of meaningful use by primary care physicians in small practices, practices of under 10 physicians. Dr. David Blumenthal We feel this is the group of physicians that is most vulnerable in this rapidly changing world, least likely to be attractive to commercial providers of these services and a very important place to start this process. Dr. David Blumenthal We want physicians to be supported in rural and in urban areas in all geographic ranges. Dr. David Blumenthal We very much want to make sure that physicians who serve the underserved and vulnerable populations get essential care to avoid any possible aggravation of disparities in the care of the American people. Dr. David Blumenthal And we intend every geographical area of the United States will be covered. Dr. David Blumenthal We announced 32 of these Regional Extension Centers; more will be announced this month. Dr. David Blumenthal They will be about changing the work of offices, not just about installing technology. Dr. David Blumenthal And the training we are trying to stand up in other programs will emphasize not just attributes of the technologies that workers need Dr. David Blumenthal to accomplish through these Regional Extension Centers, but also quality improvement techniques and process redesign techniques. Dr. David Blumenthal We also announced a $564 million program of aid to states to support health information exchange. We awarded 40 of those grants last month and more are on the way. Dr. David Blumenthal The purpose is to enlist the energy of states, the capacity of states, the resources of states in leading the creation of health information exchange. Dr. David Blumenthal We are not expecting states by themselves to make health information exchange happen. Dr. David Blumenthal What we want is for states to be a part of the process and to ensure in their jurisdiction that every part of the country is covered with a viable health information change capability. Dr. David Blumenthal We've also announced a $235 million program to support at least 15 Beacon Communities whose purpose will be to demonstrate a vision of what can be accomplished Dr. David Blumenthal with health information technology and specifically what can be accomplished in the way of measurable improvements in the health of the population and efficiency of healthcare delivery. Dr. David Blumenthal These Beacon communities are designed to light the way toward a health IT enabled future. They are to demonstrate the capability of health IT and to show the factors that are critical in a community for success. Dr. David Blumenthal If you are trying to change a health system it is at the community level that change occurs and that is why we have targeted communities rather than institutions for these particular grants. Dr. David Blumenthal We were extremely pleased to get over 130 applications for 15 slots. Dr. David Blumenthal The energy, the excitement that we saw throughout the United States, small communities, large communities, was truly, truly, rewarding and exciting. Dr. David Blumenthal Any number of these communities have told us that simply the process of coming together to apply for these funds had made for lasting change Dr. David Blumenthal in how their communities regarded health information technology and how the various stakeholders in those communities regarded each other and we want to find ways to support that process. Dr. David Blumenthal In some ways, a process that is more important than the grant funding that is available for the relatively small number of communities who will actually receive that funding. Dr. David Blumenthal Later today we will talk in another vein, about work we're doing on the Nationwide Health Information Network. Dr. David Blumenthal We continue vigorously to support the Nationwide Health Information Network as it has been known over the last several years. Dr. David Blumenthal It is a critical element of the future of health information exchange. Dr. David Blumenthal We were very pleased to see it demonstrated in a health information exchange pilot between the Veterans Administration and Kaiser Health System earlier this year, Dr. David Blumenthal as this was a part of the Veterans Administration and the Department of Defense to create a virtual lifetime health record for members of the military and veterans. Dr. David Blumenthal But we're also hard at work on a project to diversify the Nationwide Health Information Network to make it accessible to a wider variety of providers and consumers Dr. David Blumenthal who have less sophisticated capabilities and perhaps lesser needs for information exchange. Dr. David Blumenthal We see a seamless set of services available for health information exchange of which the Nationwide Health Information Network is a critical component and around which other services are available. Dr. David Blumenthal Dr. Doug Fridsma and other members of the ONC team will be discussing that Nationwide Health Information Network and its varieties at a session later today. Dr. David Blumenthal We've also announced a Workforce Training program which we hope will train in excess of 40,000 new health information technology workers. Dr. David Blumenthal We've heard from you that a shortage of workers is a critical barrier to your success, especially those of you in the provider community, but I think even some of you in the vendor community. Dr. David Blumenthal And we are training a workforce that will be diverse, primarily consisting of community college training programs, graduates of whom will get certificates Dr. David Blumenthal and will be available to do frontline work in Regional Extension Centers or in provider areas. But we are also training at a higher level as well. Dr. David Blumenthal We've also been attentive to privacy and security as a critical foundational element of our efforts to create a nationwide interoperable health information system. Dr. David Blumenthal We appointed the first Chief Privacy Officer in the history of the Department of Health and Human Services, Dr. David Blumenthal Joy Pritts, a lawyer and professor from Georgetown University and an expert on privacy issues. She started in our office last week. Dr. David Blumenthal We asked our Health Information Technology Policy Committee, through a new working group on privacy and security, Dr. David Blumenthal to give us advice on ways in which we should be enhancing the privacy and security of electronic health information systems. Dr. David Blumenthal We're working with our colleague agencies in the federal government on cyber security as part of the President's cyber security initiative. Dr. David Blumenthal There's more. But I'm going to stop there in terms of telling you what we've done. Dr. David Blumenthal I just want to finish that part of the discussion by saying that we have, we will have, by the end of my first year in office, have written most of the regulations that are required under the HITECH Act Dr. David Blumenthal and obligated almost all of the $2 billion that were set aside for us to support meaningful use and health information technology in the United States. Dr. David Blumenthal Our priorities going forward are somewhat different. We have spent the last year mostly in the job of developing policy. Now we begin the process of implementation. Dr. David Blumenthal The first implementation task we face is to finalize those three regulations that I discussed, all of which are in one form or another of proposal. Dr. David Blumenthal And we hope to do that by the end of spring so that we can really launch this new era of HITECH. Dr. David Blumenthal As I mentioned though, that will not finish our work with this regulation because no sooner will we finish those regulations Dr. David Blumenthal then we will begin with the help of our Policy Committee and our Standards Committee, to think about the next iteration of meaningful use Dr. David Blumenthal and the next iteration of standards and certification criteria and implementation specifications that are entailed by that change in definition of meaningful use. Dr. David Blumenthal We also are going to be implementing all the progarms that I've announced. Dr. David Blumenthal That is a huge job. We're going to have to grow considerably to do it effectively. Dr. David Blumenthal For Regional Extension Centers, we are going to be putting in place a Health Information Technology Research Center Dr. David Blumenthal which will develop learning collaboratives to support the Regional Extension Centers, make sure that the best practice for supporting physicians and other organizations Dr. David Blumenthal is widely shared and rapidly shared across the Regional Extension Center community, Dr. David Blumenthal making sure that there are a robust set of resources available to those Regional Extension Centers online and in more traditional paper mode Dr. David Blumenthal so that we can support providers as effectively and efficiently as possible. Dr. David Blumenthal We are going to be developing the standards and protocols for the Nationwide Health Information Network, moving those forward, Dr. David Blumenthal doing a reference implementation for what we are now calling NHIN Direct, which is an alternative approach to information exchange. Dr. David Blumenthal We are going to be encouraging the states to work with the NHIN and NHIN Direct in order for them to accomplish their goals of ensuring health information exchange. Dr. David Blumenthal And we are going to be working with states on their plans for health information exchange and on implementation work for those plans. Dr. David Blumenthal We're going to be working with universities and community colleges to use the new grant funds available to them Dr. David Blumenthal to set up their workforce training programs and to rapidly graduate their first class of new workers who can fan out Dr. David Blumenthal to Regional Extension Centers and to providers in their communities around the country. Dr. David Blumenthal We're going to be developing performance metrics for all these programs so we can manage to those objectives. Dr. David Blumenthal And in the area of privacy and security, we will have a report from our Privacy and Security Working Group. Dr. David Blumenthal We wanted to deal with all the tough questions that have vexed this field: consent, data segmentation, the balancing of security and access to electronic health information. Dr. David Blumenthal As I look back and look ahead in this olympic time, I sometimes see us as either speedskating or doing a downhill slalom. Dr. David Blumenthal We have to move fast, but we can't miss a turn. Dr. David Blumenthal We have to provide needed direction but allow for flexibility. Dr. David Blumenthal We have to allow for innovation, and we have to expect the unexpected. Dr. David Blumenthal We have to assure the liquidity of personal health information and patient information, but we have to protect its privacy and security. Dr. David Blumenthal You can see why we need your help so much. Dr. David Blumenthal But I'm optimistic. I think the wind is at our back in so, so many ways. Dr. David Blumenthal We have great bipartisan support, we have I think the inevitability of science and improvement working with us. Dr. David Blumenthal I can't imagine that in 10 years our health system will still be as dependent on the technologies for health information storage Dr. David Blumenthal and retrieval and management that Hippocrates used in 400 BC. Dr. David Blumenthal I have two children in medical school and I know they will not be happy with a system that is not empowered by the most modern methods of health information management. Dr. David Blumenthal I think the future is with hospitals and physicians and nurses and physical therapists and home health workers who adopt health information technology, who seize the moment. Dr. David Blumenthal They can do that now - at least some with the help of the range of programs I've described - or I believe they can do it later with less help. Dr. David Blumenthal Most of all, though, I am encouraged by what I regard as the power of professionalism. Dr. David Blumenthal A core attribute of professionalism - the reason why society grants my profession of medicine, the profession of nursing, all the other licensed health professions - Dr. David Blumenthal the privileges it does and the responsibilities it does is because of their technical competence, Dr. David Blumenthal a core set of abilities, skills, knowledge that add value to the larger society. Dr. David Blumenthal Now in the 21st century, those core competencies are based on science. Dr. David Blumenthal That is how the profession justifies itself - the medical profession and nursing profession and all the others - Dr. David Blumenthal that there is science to support and direct their work. Dr. David Blumenthal The idea that you can be a competent professional without being able to manage information in a modern and effective way I think defies belief. Dr. David Blumenthal I simply don't think that the larger society will continue the social contract it has with professionals unless they can demonstrate Dr. David Blumenthal that they can use and move information in the most modern possible way Dr. David Blumenthal because without that they are crippled in their ability to serve patients and to add value. Dr. David Blumenthal I also don't believe that professional pride and aspiration will allow my colleagues in the profession to resist that imperative. Dr. David Blumenthal I think in the very near future modern information management methods will be as accepted and as imperative as Dr. David Blumenthal the stethoscope, the electrocardiogram, the x-ray suite, the examining table, the operating room. Dr. David Blumenthal There will be no question then about whether the federal government ought to, is required to support Dr. David Blumenthal the acquisition and meaningful use of electronic health records and other health information technology. Dr. David Blumenthal It will be assumed as a core professional attribute. Dr. David Blumenthal And then instead of hanging back, physicians will be in the front of advancing this health information technology, as will other professions. Dr. David Blumenthal They will be demanding more sophisticated, more easy-to-use applications Dr. David Blumenthal and they will be prioritizing these investments along with MRIs and new hospital wings and new additions to their office practices. Dr. David Blumenthal I think this is the future that awaits us. It's right around the corner. Dr. David Blumenthal Some may see this as the audacity of hope. I see it as common sense, part of the inevitable march of science and of our healthcare system, Dr. David Blumenthal a healthcare system empowered by human ingenuity and by professional values. Dr. David Blumenthal Thank you for your leadership. Thank you for your help and support. Dr. David Blumenthal Thank you for listening. Let us hear from you, and best wishes for the rest of this terrific conference. Dr. David Blumenthal Thank you very much. [Applause] Liz Johnson Thank you David for your insights on all the challenges we're facing today. Liz Johnson We've been polling the audience and we always have inquiring minds that want to know - are you ready for this? Liz Johnson So we have a few questions for you. The first one is - Liz Johnson What keeps you up at night? Dr. David Blumenthal What I think about most at night, when I'm not preparing for a talk like this, is all the many things, all the many balls we have in the air that have to land together. Dr. David Blumenthal It's bringing together all these many elements into a coherent set of policies and programs. Dr. David Blumenthal The other thing that keeps me up at night is knowing that when you're dealing with something as complex as this huge social change effort we have under way - Dr. David Blumenthal and it is a change management problem, not a technology problem - Dr. David Blumenthal that you will never have certainty, that you just have to wake up everyday, do your best, ask for help, and keep on working hard. Liz Johnson Thank you. You've done a tremendous job of sharing your thoughts and telling us where you are. Liz Johnson We really appreciate that. We know you've got time commitments, and so we thank you Liz Johnson for being our Keynote this morning and please accept another round of applause from our audience. [Applause] Liz Johnson This concludes our Keynote Session. Go have a fantastic day. [Music]